Prospect Hospice

Updated 13 October 2021

Prospect Hospice is operated by Prospect Hospice Limited. It offers community and inpatient hospice care for people affected by life-limiting illness, and serves the communities of Swindon, Marlborough and North East Wiltshire.

There is an inpatient unit, a 16-bed facility which provides respite care, symptom control and care for patients at the end of life. During the COVID-19 pandemic, the inpatient unit closed from March to May 2020 and, after social distancing and infection control systems were put in place, re-opened six beds, accommodating patients in single rooms with access to outside space. During the pandemic, the service had begun to work differently, with much more crossover between teams and more focus on care in the community. Admission criteria for the inpatient unit was and continues to be focused on the provision of complex symptom control.

The hospice delivers end of life care in patients’ homes and works closely with the hospice inpatient unit depending upon care needs of patients. There is a team of clinical specialist nurses, therapy services, bereavement services, a lymphoedema service and a single point of access team. Thre is a Prospect team of consultants and specialty doctors who support the inpatient unit and home visiting. Hospice staff work closely with clinical nurse specialists and medical staff at the local acute trust. The process helps in identifying patients and their families who may benefit from support by hospice services. These patients may also need specialist care provided by the local hospital trust. The clinical nurse specialist team also provides specialist end of life care to local nursing and care homes.

The service is registered with the CQC to provide:

Diagnostic and screening procedures;

Treatment of disease, disorder and injury;

Transport services, triage and medical advice provided remotely.

The current registered manager has been in post since April 2019.

We previously carried our focused inspections of the inpatient unit in February 2018 and August 2018 and took enforcement action on both occasions. We undertook a comprehensive inspection of all services in August 2019 and rated the service as requires improvement overall. We issued a warning notice because we had concerns about weak governance systems and poor oversight of quality, including patient experience, safety and risk. The service has been monitored and a focused inspection in November 2020 found the service had met all requirements of the warning notice.

Updated 13 October 2021

Our rating of this location improved. We rated it as outstanding because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to keep as healthy as they could, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness and always respected their privacy and dignity. Staff recognised and respected the totality of their individual needs and went to great lengths to make final wishes a reality. People who used the service were active partners in their care. Staff were fully committed to working in partnership to make this a reality for each person. Staff helped patients and their families to understand their conditions. There was a strong, visible person-centred culture and staff provided emotional support to patients, families and carers in every way they could. Patients emotional and social needs were highly valued by staff and embedded in their care and treatment. The service considered itself as caring for the patient and those close to them and created systems to support care in this way. Staff supported and encouraged people to have a voice and realise their potential. Staff consistently respected choices made by the patient and those close to them and promoted this choice with other health agencies. Patients felt they were truly cared for and supported by hospice staff.
• The service planned care to meet the needs of local people, consistently took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• Leaders had an inspiring shared purpose to deliver outstanding care. They ran services well and strived to motivate staff to succeed in enhancing their skills and improving care they delivered. Leads developed systems which encouraged and supported staff to innovate and put patients and families at the centre of their care. Leads had developed and used reliable information systems. Staff understood the service’s vision and values and applied them in their work. Staff felt respected, supported and valued and were keen to let us know how leads and managers had supported them at difficult times. Staff were proud to work within the hospice as a team and felt there was no hierarchy. Staff were clear about their roles and accountabilities and felt leads engaged with them in a constructive way. Leads created ways for constructive challenge from people who use the services. The service engaged well with patients, staff and the community to plan and manage services and all staff were committed to improving services continually for the benefit of the patient.

However:

• Some groups of nursing staff had not received meaningful or consistent clinical supervision or one to one meetings since before May 2021.
• Not all staff who had contact with patients and families were trained in level two safeguarding children.

Updated 13 October 2021